The government has stoked anger with its policy of creating “centres of excellence” which close hospital departments and focus on one facet of healthcare such as stroke treatment.

The government claims the centres are more efficient and provide “targeted care” to patients, despite some local services being lost in the process.

But Mr Lansley said the “difficult decisions” that were made, which saw maternity units being shut, were not in patients’ best interests and had no support among doctors. He added that he is “not saying there should be a moratorium on change in the NHS” but that planned cuts which fly in the face of clinical evidence should not be made.

And despite a rise in demand, some health services have been shut down, Mr Lansley said.

Mr Lamb said that local bodies - ones which are “democratically accountable to local people” - should be given the power to decide which services are to be cut because such decisions should not come from central government.

Mr Burnham claimed doctors have backed the government’s cuts and said the Tory was attempting to straddle “two horses” and was only “saying what people want to hear”.

The health secretary said: “The NHS will have to make these kind of decisions in this next decade but I’m afraid both of you are trying to have it both ways.”

Mr Lamb, who mentioned the issue of party funding in the debate, pointed out that Mr Lansley’s “private office is being funded by the wife of the chief executive of a major private health company” (Care UK), which is a “conflict of interest”.

The government’s NHS contract with Care UK saw the firm make millions of pounds out of healthcare, he added.

Mr Lansley replied: “An individual person provided money to Conservative central office; that happens. Nick Clegg has been supported by individuals who support his office. That’s not a problem, that’s how it works.”

Mr Lamb added later in the debate: “We have had offers of support to my office but I have not taken them because I think it’s potentially distorting the judgements that we make.”

In turbulent times this column’s reputation as a non-panic zone serves it well. Swine flu, Alan Johnson for PM, delinquent volcanoes, we take them all in our stride. So too the Lib Dem election surge since Nick Clegg’s quite good performance in the TV debate.